1/113. Treatment for empyema with bronchopleural fistulas using endobronchial occlusion coils: report of a case.We report herein the case of a woman with bronchopleural fistulas treated with the endobronchial placement of vascular embolization coils. She was referred to our hospital to undergo lavage of a postoperative empyema. She had undergone an air plombage operation for pulmonary tuberculosis 9 years previously. However, bronchopleural fistulas occurred postoperatively and she had to continue the use of a chest drainage tube since then. Lavage of her empyema space with 5kE of OK-432 (picibanil: Chugai) plus 100 mg minocycline was performed once every 2 weeks for 3 months, and the purulent discharge from the empyema remarkably decreased. Thereafter, the bronchopleural fistulas were occluded endobronchially by the placement of vascular embolization coils. Soon after the procedure, air leakage from the fistulas was stopped and the drainage tube was removed 2 days later. The patient remains well without any additional treatment at 20 months after this treatment. As treatment for empyema with bronchopleural fistulas, it would be worth trying to lavage the empyema space with OK-432 until it is cleaned out and to plug the fistulas by the endobronchial placement of embolization coils, before such radical operations as thoracoplasty and space-filling of the empyema are considered.- - - - - - - - - - ranking = 1keywords = empyema (Clic here for more details about this article) |
2/113. Cholelithoptysis and pleural empyema.We report a case of delayed cholelithoptysis and pleural empyema caused by gallstone spillage at the time of laparoscopic cholecystecomy. An occult subphrenic abscess developed, and the patient became symptomatic only after trans-diaphragmatic penetration occurred. This resulted in expectoration of bile, gallstones, and pus. Spontaneous decompression of the empyema occurred because of a peritoneo-pleuro-bronchial fistula. This is the first case of such managed nonoperatively and provides support for the importance of intraoperative retrieval of spilled gallstones at the time of laparoscopic cholecystectomy.- - - - - - - - - - ranking = 0.6keywords = empyema (Clic here for more details about this article) |
3/113. Conservative management of a transdiaphragmatic fistula.case reports of transdiaphragmatic fistulas connecting subphrenic collections and empyemas are uncommon. We report the rare complication of a fistulous connection between a subphrenic collection and the bronchial tree.- - - - - - - - - - ranking = 0.1keywords = empyema (Clic here for more details about this article) |
4/113. Fatal hemorrhage complicating carcinoma of the esophagus. Report of four cases.Four cases of esophageal carcinoma complicated by fatal hemorrhage are reported. All four patients had recently completed radiation therapy. An aortoesophageal fistula was present in two cases; fibrinoid necrosis of the esophageal arteries was present in the other two. The esophageal tumor was localized in two cases and had disappeared in one case. In one patient it had metastasized widely. Ninety-nine other reports of esophageal cancer and fatal hemorrhage are reviewed from the literature. Aortoesophageal fistula was the cause of hemorrhage in 78 cases. Occlusion of the vasa vasorum by thrombosis, inflammation, neoplastic cells or radiation injury appears to be the cause of aortic necrosis and fistula formation. Prompt surgical approach, if possible, should be used to control hemorrhage, as the primary tumor may be localized to the esophagus only.- - - - - - - - - - ranking = 0.00073765047929713keywords = inflammation (Clic here for more details about this article) |
5/113. Aortocolic fistula, a lethal cause of lower gastrointestinal bleeding: report of a case.Aortocolic fistula occurs with spontaneous rupture of aortic and iliac aneurysms into the sigmoid colon, or due to involvement of the aneurysmal wall by acute diverticulitis. In the eight cases reviewed, this complication proved uniformly lethal, although sufficient clinical findings were present for diagnosis, and adequate time was available for a planned therapeutic approach. Lower gastrointestinal bleeding in the patient who has an aortic aneurysm and left-lower-quadrant inflammation suggests the presence of an aortocolic fistual. angiography should be performed during a bleeding episode to confirm the diagnosis. Surgical correction consists of an axillofemoral by pass graft, excision of the aortic aneurysm, and a Hartmann procedure.- - - - - - - - - - ranking = 0.00073765047929713keywords = inflammation (Clic here for more details about this article) |
6/113. Gastric seromuscular and omental pedicle flap for bronchopleural fistula after pneumonectomy.We report a case of postpneumonectomy bronchopleural fistula treated using a gastric seromuscular and omental pedicle flap and maintaining good postoperative respiratory function. A 76-year-old man underwent right pneumonectomy with regional lymph node dissection for squamous cell carcimoma of the lung. Five weeks later, a bronchopleural fistula occurred. empyema with the bronchopleural fistula was diagnosed and chest tube drainage implemented immediately. Despite the drainage, signs of inflammation persisted and the patient's nutrition did not improve leading to surgery, on August 18, 1997. The bronchopleural fistula was closed by horizontal suture proximal to the stapling sutured line. A gastric seromuscular and omental pedicle flap was sutured as a cover over the bronchial stump. Postoperative analysis of respiratory function and arterial blood gas showed good results.- - - - - - - - - - ranking = 0.00073765047929713keywords = inflammation (Clic here for more details about this article) |
7/113. Pleuro-biliary fistula from a ruptured choledochal cyst.We present a case of rupture of an intrahepatic choledochal cyst through the diaphragm resulting in a pleuro-biliary fistula and a right pleural empyema which was surgically treated. Hepatobiliary complications resulting in biliary empyema of the pleura are discussed.- - - - - - - - - - ranking = 0.2keywords = empyema (Clic here for more details about this article) |
8/113. hand-assisted laparoscopic harvesting of an omental pedicle in the treatment of complicated chronic empyema.We describe a new method for hand-assisted laparoscopic harvesting of an omental pedicle and its use in the treatment of chronic empyema with a bronchopulmonary fistula. This technique may also be appropriate as a less invasive surgical procedure in the treatment of a number of other thoracic infectious conditions.- - - - - - - - - - ranking = 0.5keywords = empyema (Clic here for more details about this article) |
9/113. Epiphrenic diverticula, esophageal carcinoma and esophagopleural fistula.A case report of a patient with two epiphrenic diverticula and a squamous cell carcinoma within one of them is presented. Moreover, a pleural empyema and an esophagopleural fistula appeared following the neoplasic diverticulum perforation. Only a few cases have been previously described in the English-language literature. An additional one is now presented.- - - - - - - - - - ranking = 0.1keywords = empyema (Clic here for more details about this article) |
10/113. The use of a Dumon stent for the treatment of a bronchopleural fistula.We report the successful management of a bronchopleural fistula with bronchial stent placement combined with irrigation of the empyema cavity. A bronchopleural fistula occurred in a 67-year-old man after a right upper lobectomy for lung cancer. Resuturing of the bronchial stump plus omental wrapping and subsequent closure of the open stump with a pedicled flap of intercostal muscle were not effective. Consequently, we placed a Dumon stent in the right main bronchus to close the stump.- - - - - - - - - - ranking = 0.1keywords = empyema (Clic here for more details about this article) |
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